Abstract
Straight laparoscopic total abdominal colectomy (TAC) can be performed electively for indications such as slow transit constipation and hereditary polyposis syndromes, as well as in urgent situations for inflammatory and infectious conditions, most commonly ulcerative colitis. In the latter cases, an end ileostomy, as opposed to an ileorectal anastomosis, is usually performed, reserving reconstruction for a later date. Perceived benefits include fewer intra-abdominal adhesions, incisional hernias, and wound infections, as well as improved cosmesis—albeit with longer operative times than hand-assisted or traditional open approaches. Numerous extraction sites can be used, including the ileostomy site or natural orifices, obviating an additional transabdominal incision. Despite being technically difficult with the attendant risks of laparoscopic colon surgery, straight laparoscopic TAC can be performed safely with significant potential benefit to the patient.
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The abdominal portion of a total proctocolectomy in a patient undergoing a straight laparoscopic approach (Video by Sang Lee, MD) (MP4 153,660 kb)
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Hayman, A.V., Dozois, E.J. (2015). Total Abdominal Colectomy: Straight Laparoscopic Approach. In: Ross MD FACS FASCRS, H., Lee MD, FACS, FASCRS, S., Mutch MD, FACS, FASCRS, M., Rivadeneira MD, MBA,FACS, FASCRS, D., Steele M.D., FACS, FASCRS, S. (eds) Minimally Invasive Approaches to Colon and Rectal Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1581-1_8
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